Modifications of circadian cortisol rhythm by cyclic and continuous total enteral nutrition.
Modifications of circadian cortisol rhythm by cyclic and continuous total enteral nutrition.
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通过循环和连续全肠内营养改变昼夜皮质醇节律。
DOI：
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发表时间：
1989
影响因子：
1.6
通讯作者：
H. Kato
中科院分区：
文献类型：
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作者：
M. Saito;K. Nishimura;H. Kato
为了阐明饮食摄入模式与肾上腺皮质昼夜节律之间的关系，我们在24小时内以4小时为间隔测量了18例处于植物状态并接受全肠内营养（TEN）4周的患者的血浆皮质醇水平。一组6例患者在一天内连续给予流质饮食（连续TEN），而另外两组在一天的有限时间内接受每日肠内喂养，无论是在白天0800 h至2000 h（白天TEN，6例患者）还是在夜间2000 h至0800 h（夜间TEN，6例患者）。在昼夜TEN患者中，有一个明确的皮质醇节律，峰值为0800 h，其模式与正常受试者中已确立的皮质醇节律非常相似。夜间TEN患者也有皮质醇节律，但高峰出现在1600 h。两组之间的节律幅度没有明显差异。连续性TEN患者没有表现出任何一致的昼夜皮质醇节律。血糖、胰岛素和游离脂肪酸的血浆水平也显示昼夜节律波动，与昼夜和夜间TEN组的饮食输注模式相对应，并且在连续TEN组中全天几乎保持恒定。我们从这些结果中得出结论，饮食摄入的时间可能对人类的昼夜皮质醇节律有同步作用，就像在实验室动物中一样。
To clarify the relationship between the pattern of diet intake and the circadian adrenocortical rhythm, we measured plasma cortisol levels at 4-h intervals over a 24-h period in 18 patients who were in the vegetative state and had been receiving total enteral nutrition (TEN) for 4 weeks. One group of 6 patients was given a liquid diet intraduodenally and continuously throughout a day (continuous TEN), whereas the two other groups received their daily enteral feeding during a restricted time of day, either in the daytime from 0800 h to 2000 h (diurnal TEN, 6 patients) or in the nighttime from 2000 h to 0800 h (nocturnal TEN, 6 patients). In patients with diurnal TEN, there was a clear cortisol rhythm with a peak of 0800 h, whose pattern was quite similar to the well-established cortisol rhythm in normal subjects. Patients with nocturnal TEN also showed a cortisol rhythm, but the peak appeared at 1600 h. There was no appreciable difference in the amplitude of the rhythm between the two groups. Patients with continuous TEN did not show any consistent circadian cortisol rhythms. Plasma levels of glucose, insulin, and free fatty acids also showed circadian fluctuations corresponding to the pattern of diet infusion in the groups with diurnal and nocturnal TEN, and remained almost constant throughout a day in the group with continuous TEN. We conclude from these results that the timing of diet intake may have a synchronizing effect on the circadian cortisol rhythm in man, as it does in laboratory animals.